Provider Demographics
NPI:1316764103
Name:WITT, FRANCES ELAINE (REG ASSOCIATE)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:ELAINE
Last Name:WITT
Suffix:
Gender:F
Credentials:REG ASSOCIATE
Other - Prefix:
Other - First Name:FRAN
Other - Middle Name:
Other - Last Name:WITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1429 SW 14TH AVE APT 309
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-6084
Mailing Address - Country:US
Mailing Address - Phone:815-520-5835
Mailing Address - Fax:
Practice Address - Street 1:1827 NE 44TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1443
Practice Address - Country:US
Practice Address - Phone:503-320-7136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR10037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health